Design of the spacer for brachytherapy using <sup>198</sup>Au grain for carcinoma of the tongue as a tool of perioperative oral management
Design of the spacer for brachytherapy using <sup>198</sup>Au grain for carcinoma of the tongue as a tool of perioperative oral management
复制标题
使用 <sup>198</sup>Au 颗粒治疗舌癌的近距离放射治疗间隔器的设计作为围手术期口腔治疗的工具
DOI：
10.1016/j.jpor.2018.07.002
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发表时间：
2018
影响因子：
3.6
通讯作者：
Sasaki K
中科院分区：
文献类型：
--
作者：
Suenaga H;Tamahara T;Dodo M;Murakami T;Sasaki S;Ito K;Jingu K;Koseki T;Sasaki K
患者：71岁和73岁的男性在舌癌（T1N0M0）治疗期间访问围手术期口腔护理支持中心接受围手术期口腔管理。为了提高患者近距离放射治疗期间的生活质量，同时预防放射相关并发症，包括198Au粒子近距离放射治疗引起的骨放射性坏死，设计了上颌骨和下颌骨垫片，并考虑了隔离病房的佩戴条件。间隔器采用单侧设计，并考虑到舌在白天和晚上的活动性。然后，在石膏模型上加厚垫片，显示舌中的癌病变，以确保从下颌体、上颌骨和舌下腺到嵌入舌中的辐射源的距离。讨论内容：舌压使垫片尽可能小，仅在癌灶周围增厚，使患者能够舒适地佩戴垫片，同时保持辐射源与周围正常组织之间的足够距离。避免使用易断裂的硬材料，以便患者能够安全使用融合器，而不会意外吞咽断裂碎片。此外，考虑到舌头在睡眠姿势中的向上运动，还准备了上间隔件以保护上颌骨。计算机模拟显示，我们的间隔器的设计在减少辐射方面有足够的效果，可以防止上颌骨和下颌骨体的放射性骨坏死。结论：本报告证明了考虑患者佩戴条件的间隔器在近距离放射治疗中改善其QOL的重要性。© 2018 Japan Prosthodontic Society。由爱思唯尔有限公司出版。保留所有权利。
Patients: Seventy-one and 73 years-old males visited a perioperative oral care support center to receive perioperative oral management during tongue cancer (T1N0M0) treatment. To improve their quality of life (QOL) during brachytherapy while preventing radiation-related complications including osteoradionecrosis due to 198Au grain brachytherapy, spacers for their maxilla and mandible were designed with consideration of wearing condition at an isolation ward. The spacer was created with unilateral design and with consideration of the tongue mobility during day and night. Then, the spacer was thickened on the plaster model, demonstrating the cancer lesion in the tongue in order to secure the distances from the mandibular body, maxilla and sublingual gland to the radiation sources embedded in the tongue. Discussion: Tongue impression made the spacers as small as possible by thickening just around the cancer lesions so that the patients could wear them comfortably, while keeping adequate distance between the radiation sources and peripheral normal tissues. Breakable hard materials were avoided so that the patients were able to utilize the spacers safely without accidentally swallowing a broken fragment. Additionally, considering the upward movement of the tongue in a sleeping posture, the upper spacers were also prepared to protect the maxillae. Computer simulation revealed that the design of our spacers had enough effect on a reduction in radiation to prevent osteoradionecrosis in the maxilla as well as mandibular body.Conclusions: This report demonstrated the importance of the spacers created with consideration of patients’ wearing condition to improve their QOL during brachytherapy.© 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.